Individual
LISA M SPORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
307 S WEST ST, NIXA, MO 65714-8413
(417) 494-5031
(417) 551-4146
Mailing address
307 S WEST ST, NIXA, MO 65714-8413
(417) 494-5031
(417) 551-4146
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2011016318
MO
Other
Enumeration date
06/08/2011
Last updated
10/05/2022
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